Double-armed sutures, i.e., a surgical suture with a needle at each end, are well known and commonly used, e.g., in cardiovalve replacement surgery. This type of suture is optionally manufactured with a pre-centered pledget, i.e., a cushioning pad to prevent the suture from cutting into the tissue, which is also known in the art. Such sutures are frequently packaged in sets to supply an adequate number to advance the surgery without requiring opening and handling multiple packages. The sutures are typically arranged in the package with the needle ends of each suture grouped together such that the two ends of each suture can be identified. It is preferable for the package to be able to dispense each suture by grasping one or both of the associated needles with a needle holder. Prior art packages for multiple double-armed sutures are exemplified by U.S. Pat. No. 4,034,850, which is incorporated herein by reference for its disclosure of suture packaging methods and apparatus. The package disclosed in the '850 patent winds the individual sutures within the package in a figure eight pattern.
During surgery, a rhythm is developed between the scrub nurse and the surgeon in passing the sutures to the surgeon. If a suture becomes tangled upon removal from the package, this rhythm is interrupted and lengthens the surgery, which poses a danger to the patient. Accordingly, it remains an objective in this field to provide suture packaging that minimizes the chances of suture tangling.
Surgeons variously prefer to handle either a single needle holder, which is sequentially used to grasp and insert a first needle of the suture then the second needle, or a pair of needle holders, which are used for simultaneously grasping both needles. It is desirable for each needle to be presented in the package with adequate space around it for the scrub nurse to readily grasp each needle individually with a needle holder. Spatial separation of the needles must not disturb their visual grouping, i.e., it must be apparent which two needles are connected to the same suture. Furthermore, spatial separation of the needles cannot be allowed to appreciably enlarge the needle package to the degree that it becomes unwieldy or that it cannot be accommodated in the standard storage devices present in the operating room and supply cabinets.
It is therefore an object of the present invention to provide a new and improved package for multiple double-armed sutures that prevents tangling of the sutures and, on sutures so supplied, keeps a pledget centered on the suture upon withdrawal from the package. It is also desirable to have a package that is easy to handle, yet is capable of holding multiple sutures. Another object of the invention is to provide a package that applies minimal compression pressure to the sutures, such that the sutures are loose within the package, and are therefore easy to remove.